Publications by authors named "Daniel Pecsi"
Background: Endoscopic retrograde cholangiopancreatography (ERCP) is essential for the minimally invasive management of biliary and pancreatic disorders. Under certain indications, performing ERCP without delay during the weekend can be important for improving outcomes.
Objectives: To compare the outcomes of ERCP performed on weekends and holidays with those of regular weekday ERCPs.
Background And Study Aims: Endoscopic biliary stent placement is a minimally invasive intervention for patients with biliary strictures. Stent patency and function time are crucial factors. Suprapapillary versus transpapillary stent positioning may contribute to stent function time, so a meta-analysis was performed in this comparison.
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- Excessive alcohol consumption is a major cause of recurrent acute pancreatitis (AP), but effective treatments to prevent its recurrence, like psychological therapies, are not widely implemented in practice.
- A study analyzed 99 patients with alcohol-induced AP, where a 30-minute brief intervention (BI) by a physician led to significant reductions in alcohol consumption and related blood markers (GGT and MCV).
- After one month, 79% of patients reported being alcohol-free, indicating that BI could be a promising method to help prevent future cases of AP, though further research is needed to optimize its use.
Article Synopsis
- There is currently no agreement on using blood tests like serum S100B and serum LDH to monitor melanoma recurrence, though the 2008 meta-analysis showed elevated S100B levels correlate with worse survival.
- This systematic review analyzed data from 6 studies with over 1,000 melanoma patients, finding that serum S100B is better at identifying disease relapse compared to serum LDH.
- While both biomarkers provide valuable prognostic information, S100B is a reliable marker for detecting melanoma recurrence, suggesting that further research on serum biomarkers is needed.
Background: Metabolic risk factors, such as obesity, hypertension, and hyperlipidemia are independent risk factors for the development of various complications in acute pancreatitis (AP). Hypertriglyceridemia dose-dependently elicits pancreatotoxicity and worsens the outcomes of AP. The role of hyperglycemia, as a toxic metabolic factor in the clinical course of AP, has not been examined yet.
View Article and Find Full Text PDFIntroduction: Current guidelines recommend intravenous (IV) proton pump inhibitor (PPI) therapy in peptic ulcer bleeding (PUB). We aimed to compare the efficacy of oral and IV administration of PPIs in PUB.
Methods: We performed a systematic search in 4 databases for randomized controlled trials, which compared the outcomes of oral PPI therapy with IV PPI therapy for PUB.
Article Synopsis
- Chronic pancreatitis (CP) is a severe condition with no specific treatment, making early diagnosis essential for better outcomes.
- A study analyzed data from both acute pancreatitis (AP) and chronic pancreatitis (CP) patients, revealing that experiencing three or more episodes of AP significantly increases the risk of developing CP.
- Findings suggest that patients with three or more recurrent AP episodes could be classified as having early chronic pancreatitis (ECP), allowing for earlier diagnosis without extra healthcare costs.
Article Synopsis
- Some studies indicate that diagnostic tests may be less accurate in detecting peptic ulcer bleeding (PUB), prompting a meta-analysis to evaluate their effectiveness.
- A systematic review of 40 studies focused on various diagnostic strategies, highlighting that no single test outperformed the others significantly, and combined testing strategies yielded higher sensitivities but lower specificities.
- The conclusion suggests that while combined tests could be beneficial due to their higher sensitivity, the variability among studies presented challenges in making direct comparisons of diagnostic strategies.
Article Synopsis
- Endoscopic retrograde cholangiopancreatography (ERCP) is a crucial procedure for treating acute biliary pancreatitis (ABP) and cholangitis, particularly when there's a blockage in the bile duct.
- A study compared the difficulties of ERCP in 240 ABP patients versus 250 patients with acute cholangitis (AC) without ABP; results showed that accessing the bile duct was more complex in ABP cases.
- Findings indicated that ABP patients experienced longer cannulation times and required more advanced techniques, suggesting that these cases necessitate the skill of an experienced endoscopist.
Article Synopsis
- * Results showed that patients with FLD had a significantly higher risk of death, severe AP, and longer hospital stays compared to those without it, while NAFLD also contributed to severe AP and longer recovery times.
- * Both FLD and NAFLD were identified as independent risk factors for more severe cases of AP, suggesting they should be included in prognosis assessments to enhance patient care and outcome predictions.
Acute gastritis is often untreatable by acid secretion-inhibiting drugs. Understanding the protective mechanisms including the role of Transient Receptor Potential Ankyrin1 (TRPA1) and Vanilloid1 (TRPV1) channels localized on capsaicin-sensitive afferents and non-neuronal structures might identify novel therapeutic approaches. Therefore, we characterized a translational gastritis model using iodoacetamide (IAA) and investigated TRPA1/V1 expressions.
View Article and Find Full Text PDFBackground: Hypertriglyceridemia is the third most common cause of acute pancreatitis (AP). It has been shown that hypertriglyceridemia aggravates the severity and related complications of AP; however, detailed analyses of large cohorts are contradictory. Our aim was to investigate the dose-dependent effect of hypertriglyceridemia on AP.
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- Lactose intolerance affects about 47% of Eastern Europeans, with a study in Hungary finding lower prevalence rates of 29.5% for lactose intolerance and 49.6% for lactose maldigestion among 264 symptomatic patients.
- Small intestinal bacterial overgrowth (SIBO) was identified in 60% of symptomatic patients, which contributed to false results in traditional lactose testing methods.
- The study suggests that combining lactose breath and tolerance tests, along with monitoring for SIBO, can improve diagnostic accuracy and reduce false positives in assessing lactose-related issues.
Double Stenting for Malignant Biliary and Duodenal Obstruction: A Systematic Review and Meta-Analysis.
Clin Transl Gastroenterol
April 2020
Article Synopsis
- A systematic literature review was conducted to evaluate the effectiveness and best methods for palliative double stenting in cases of malignant duodenobiliary obstruction, comparing this technique with surgical double bypass.
- The review included 80 studies, revealing high technical (97%) and clinical success rates (92%) for double stenting, as well as showing that endoscopic biliary stenting had a higher clinical success than surgery (97% vs 86%).
- Despite having fewer adverse events (13% vs 28%), double stenting required more reinterventions (21% vs 10%) compared to surgical options, with ERCP being the best option for minimizing adverse events.
Introduction: Acute pancreatitis (AP) is a life-threatening inflammatory disease of the exocrine pancreas which needs acute hospitalisation. Despite its importance, we have significant lack of knowledge whether the lifestyle factors elevate or decrease the risk of AP or influence the disease outcome. So far, no synthetising study has been carried out examining associations between socioeconomic factors, dietary habits, physical activity, chronic stress, sleep quality and AP.
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- Pancreatic pseudocysts and walled-off necrosis can be treated through endoscopic, percutaneous, or surgical methods, but their effectiveness varies.
- A literature review showed that endoscopic drainage (ED) generally leads to better clinical success and lower recurrence rates compared to percutaneous drainage (PD) and has shorter hospital stays than surgery.
- However, ED has a lower overall clinical success rate and higher recurrence compared to surgical methods, while PD shows the lowest success and highest recurrence, making both endoscopy and surgery the more favorable options over PD.
Article Synopsis
- Researchers examined the effectiveness of C-reactive protein (CRP) and white blood cell count (WBC) in assessing acute pancreatitis (AP) through a review of existing studies and data analysis of 1435 patient episodes.
- The study found that CRP levels were not reliable indicators of mortality or severity in AP cases, with low accuracy in predictions regardless of when the levels were measured.
- However, using CRP levels within the first 24 hours after pain onset as a criterion for including patients in clinical trials significantly increased the rates of severe cases and mortality, thus potentially simplifying the patient selection process for trials.
Background: Acute pancreatitis (AP) is an inflammatory condition that can lead to late consequences. Recurrent AP (RAP) develops in 20% of patients and chronic pancreatitis (CP) occurs in 7%-12.8%.
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- Unwarranted use of antibiotics in acute pancreatitis is a widespread issue, and the reasoning behind it is not well understood, prompting a study to improve prescription practices.
- The research involved systematic data collection, a global questionnaire, analysis of existing patient data, and the application of a grading system to develop evidence-based recommendations.
- Findings showed a lack of consensus on when to start antibiotics, with significant variability in usage rates, and highlighted that procalcitonin is a more reliable marker for infection than traditional indicators like WBC and CRP, leading to recommendations for reducing unnecessary antibiotic treatment.
In cases of difficult biliary cannulation, transpancreatic sphincterotomy (TPS) can be an alternative approach of biliary access. However, its success and safety profile have not been studied in detail. A systematic review and meta-analysis were performed to study the overall cannulation success and adverse events of TPS.
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- This study investigates the effectiveness of endoscopic retrograde cholangiopancreatography (ERCP) in treating acute biliary pancreatitis (ABP) in Hungary, highlighting the challenges of determining when to use the procedure.
- Out of 356 ABP patients, 75% underwent ERCP, but the procedure had suboptimal indicators, with biliary cannulation success rates at only 84% and higher complications in cases of unsuccessful cannulation and clearance.
- The research concludes that timely and effective ERCP is essential for better patient outcomes, as delays in performing the procedure can lead to increased local complications.
Our meta-analysis indicated that aging influences the outcomes of acute pancreatitis (AP), however, a potential role for comorbidities was implicated, as well. Here, we aimed to determine how age and comorbidities modify the outcomes in AP in a cohort-analysis of Hungarian AP cases. Data of patients diagnosed with AP by the revised Atlanta criteria were extracted from the Hungarian Registry for Pancreatic Patients.
View Article and Find Full Text PDFBackground And Purpose: Irritable bowel syndrome (IBS) affects 10%-20% of the adult population and is characterized by abdominal symptoms without relevant organic disease. There are numerous clinical trials available investigating the relationship between IBS, lactose maldigestion (LM), and lactose intolerance (LI), but there have been no meta-analyses on this topic yet. We aimed to assess the prevalence of LM, objective and subjective (self-reported) LI in IBS patients compared to healthy controls (HC) without IBS.
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